Background: Traumatic amputation of the tip of the finger is a common injury both in domestic and industrial settings and it is the most common injury seen in upper extremity. Several options for the management of this type of injury are available. These options include surgical and conservative management. The main aim of these options is coverage and retaining sensation of the finger tip. Objective: The aim of this study is to compare sensory recovery using two point discrimination test and sensory nerve conductions following conservative management versus local flaps in finger tip injuries without bone exposure. Methods: Sixty-four fingers in 58 patients are included in this study. Thirty-three finger tips were allocated to group 1 (conservative management) and 31 to group 2 (local non sensate flaps). Two point discrimination test and sensory nerve conductions were done after one year. The incidence of infection, joint stiffness, cold intolerance and hypersensitivity was also noted. Results: There was a highly statistically significant difference between the two groups as regards the two point discrimination test, and peak latency, amplitude and conduction velocity of sensory nerves (p≤0.001) with better values in group 1. Conclusion: sensory recovery presented by two point discrimination test and sensory nerve conductions in patients under conservative management is much better than that achieved with local flaps and there is no statistical difference in the incidence of cold intolerance or hypersensitivity between the two methods of treatment after one year. (Egypt J Neurol Psychiat Neurosurg. 2010; 47(2): 325-330)
Key words: Fingertip injuries- two point discrimination - sensory nerve conductions-conservative management- local flaps.
Correspondence to Neveen Mohammed El-Fayoumy, clinical neurophysiology unit, Cairo University; Egypt. TEL.: +20123714317. Email:neveenfayomy@hotmail.com.